Method of forming a member of an end effector

ABSTRACT

A method of forming a jaw member of an end effector includes providing a metal support base; engaging a plurality of ceramic stops to the metal support base; and coupling an insulative plate and a sealing plate to the metal support base by aligning the plurality of ceramic stops through a plurality of openings defined in the insulative plate and a plurality of openings defined in the sealing plate.

CROSS REFERENCE TO RELATED APPLICATION

The present application claims the benefit of and priority to U.S.Provisional Application Ser. No. 62/051,504, filed on Sep. 17, 2014, theentire contents of which are incorporated herein by reference.

BACKGROUND

The present disclosure relates to methods of forming components ofsurgical instruments and, more particularly, to methods of forming jawmembers having ceramic rods that act as a guide during assembly of thejaw members, control a gap distance between the jaw members, and provideelectrical insulation between the jaw members.

TECHNICAL FIELD

Electrosurgical instruments, e.g., electrosurgical forceps, utilize bothmechanical clamping action and electrical energy to effect hemostasis byheating tissue to coagulate and/or cauterize tissue. Certain surgicalprocedures require more than simply cauterizing tissue and rely on theunique combination of clamping pressure, precise electrosurgical energycontrol, and gap distance (i.e., distance between opposing jaw memberswhen closed about tissue) to “seal” tissue.

One method of controlling the gap distance uses one or more ceramic dotsor stop members on one or both jaw members. The stop members aretypically deposited atop components of one or more jaw members, e.g.,vapor deposited onto sealing plates. The stop members project from thetissue engaging surface of one or both jaw members and control theseparation distance between opposing jaw members when closed abouttissue. Since the stop members are typically made from ceramic, the stopmembers are stable at elevated temperatures and usually exhibit lowthermal and electrical conductivities. In addition, ceramic materialshave high melting points and are resistant to oxidation, corrosion, orother forms of degradation to which metals are usually more prone.However, stop members are usually applied to the sealing plate using aprocess involving very high temperatures, which limit the material thatmay be used for the sealing plates.

SUMMARY

In one aspect of the present disclosure, a method of forming a jawmember of an end effector is provided. The method includes providing ametal support base, an insulative plate having a plurality of openingsdefined therethrough, and a sealing plate having a plurality of openingsdefined therethrough. A plurality of ceramic stops having apredetermined length are engaged to the metal support base. Theinsulative plate and the sealing plate are coupled to the metal supportbase by aligning the plurality of ceramic stops through the plurality ofopenings defined in the insulative plate and the plurality of openingsdefined in the sealing plate such that a second end of each ceramic stopprojects a predetermined distance relative to a tissue-engaging surfaceof the sealing plate.

In some embodiments, the method may further include overmolding aninsulative housing around the metal support base.

In some embodiments, the insulative plate may be formed by injectionmolding.

In some embodiments, each of the plurality of ceramic stops may have acylindrical configuration. Each of the plurality of ceramic stops maydefine a longitudinal axis therealong and the tissue-engaging surface ofeach of the plurality of ceramic stops may define a plane inperpendicular relation to each respective longitudinal axis.

In some embodiments, the insulative plate may be fabricated fromplastic.

In some embodiments, the method may further include forming alongitudinal knife slot through each of the insulative plate and thesealing plate and aligning the slots in registration with one another.The plurality of openings of the insulative plate and the plurality ofopenings of the sealing plate may be formed adjacent each respectivelongitudinal knife slot.

In some embodiments, upon coupling the insulative plate and the sealingplate to the metal support base the plurality of ceramic stops mayproject from the sealing plate about 0.001 inches to about 0.006 inches.

In another aspect of the present disclosure, another method of forming ajaw member of an end effector is provided. The method includes providinga metal support base, an insulative plate having a plurality of openingsdefined therethrough, and a sealing plate having a plurality of openingsdefined therethrough. The insulative plate and the sealing plate arecoupled to the metal support base. A plurality of ceramic stops areguided through the plurality of openings defined in the insulative plateand the plurality of openings defined in the sealing plate and intoengagement with the metal support base such that a second end of eachceramic stop projects a predetermined distance relative to atissue-engaging surface of the sealing plate.

In some embodiments, the method may further include overmolding aninsulative housing around the metal support base. The plurality ofceramic stops may be placed into engagement with the metal support baseconcurrently with overmolding the insulative housing around the metalsupport base.

BRIEF DESCRIPTION OF THE DRAWINGS

Embodiments of the present disclosure are described herein withreference to the accompanying drawings, wherein:

FIG. 1 is a perspective view of an endoscopic surgical instrumentconfigured for use in accordance with the present disclosure;

FIG. 2 is a front, perspective view of an end effector of the surgicalinstrument shown in FIG. 1;

FIG. 3 is an enlarged, perspective view of a jaw member of the endeffector shown in FIG. 2;

FIG. 4A is an exploded view of the jaw member shown in FIG. 3; and

FIG. 4B is an exploded view of another jaw member of the end effectorshown in FIG. 2.

DETAILED DESCRIPTION

Embodiments of the presently disclosed electrosurgical instrument aredescribed in detail with reference to the drawings, in which likereference numerals designate identical or corresponding elements in eachof the several views. As used herein, the term “distal” refers to thatportion of the surgical instrument or component thereof, farther fromthe user, while the term “proximal” refers to that portion of thesurgical instrument, or component thereof, closer to the user.

With reference to FIG. 1, a surgical instrument, such as, for example,an endoscopic forceps 10 is provided. For the purposes herein, either anendoscopic instrument or an open instrument (not explicitly shown) maybe utilized in accordance with the present disclosure. Forceps 10includes a pair of jaw members 110, 210 each having a plurality of stopmembers, such as, for example, ceramic stops 122 a-g, 222 a-g (FIGS. 4Aand 4B) connected directly to metal support bases 120, 220 of respectivejaw members 110, 210. Ceramic stops 122 a-g, 222 a-g (FIGS. 4A and 4B)being directly connected to metal support bases 120, 220 of respectivejaw members 110, 210 assist in the assembly of jaw members 110, 210 andprovide a separation or gap distance between jaw members 110, 210 whenapproximated, as described in greater detail below.

With continued reference to FIG. 1, forceps 10 defines a longitudinalaxis “X-X” and includes a housing 20, a handle assembly 30, a rotatingassembly 40, a trigger assembly 50, a switch 60, a shaft 70 extendingdistally from housing 20, and an end effector assembly 100. Shaft 70 hasa proximal end 72 that mechanically engages housing 20 and a distal end74 configured to mechanically engage end effector assembly 100. Housing20 contains the internal working components of forceps 10. Reference maybe made to commonly-owned U.S. Pat. No. 7,156,846, the entire contentsof which are hereby incorporated by reference herein, for a detaileddescription of the internal working components of housing 20.

End effector assembly 100 includes the pair of opposing jaw members 110and 210 coupled to distal end 74 of shaft 70. Jaw members 110, 210 aremoveable between a spaced-apart position and an approximated positionfor grasping tissue therebetween. End effector assembly 100 is designedas a unilateral assembly, e.g., jaw member 210 is fixed relative toshaft 70 and jaw member 110 is moveable about a pivot 103 relative toshaft 70 and fixed jaw member 210. In some embodiments, end effectorassembly 100 may be configured as a bilateral assembly, e.g., where bothjaw member 110 and jaw member 210 are moveable about pivot 103 relativeto one another and to shaft 70.

With continued reference to FIG. 1, forceps 10 also includes anelectrosurgical cable 80 that connects forceps 10 to a generator (notexplicitly shown) or other suitable power source. In some embodiments,forceps 10 may be configured as a battery-powered instrument. Cable 80includes a wire or wires (not explicitly shown) extending therethroughthat has sufficient length to extend through shaft 70 in order toprovide electrical energy to at least one of jaw members 110 and 210 ofend effector assembly 100. Trigger 52 of trigger assembly 50 may beselectively depressed to advance a knife (not explicitly shown) betweenjaw members 110, 210 to cut tissue grasped therebetween. Switch 60 isselectively activated to supply electrosurgical energy to jaw members110, 210.

Handle assembly 30 includes a fixed handle 32 and a moveable handle 34.Fixed handle 32 is integrally associated with housing 20 and moveablehandle 34 is moveable relative to fixed handle 32. Rotating assembly 40is rotatable in either direction about longitudinal axis “X-X” to rotateend effector 100 about longitudinal axis “X-X.” Moveable handle 34 ofhandle assembly 30 is coupled to a drive assembly (not explicitly shown)that, together, mechanically cooperate to impart movement of jaw members110 and 210 between the spaced-apart position and the approximatedposition to grasp tissue disposed between jaw members 110, 210. Moveablehandle 34 is biased from fixed handle 32 and, correspondingly, jawmembers 110, 210 are in the spaced-apart position. Moveable handle 34 iscompressible from a spaced-apart position to a compressed positioncorresponding to the approximated position of jaw members 110, 210.

With reference to FIGS. 2, 3, 4A, and 4B, jaw members 110, 210 eachinclude an insulative housing 102, 202, metal support base 120, 220, aninsulative plate 130, 230, and a sealing plate 140, 240, respectively.As jaw members 110, 210 clamp together around tissue, stop members 122a-g, 222 a-g maintain a gap distance between jaw members 110, 210. Insome embodiments, the gap distance may be about 0.001 inches to about0.006 inches.

With reference to FIGS. 4A and 4B, metal support bases 120, 220 includeproximally extending flanges 124, 224, respectively. Flanges 124, 224each include an elongated angled cam slot 126, 226 defined therethroughconfigured to engage an actuator rod (not explicitly shown) that drivesthe opening and closing of the jaw members 110, 210 as the actuator rodmoves through cam slots 126, 226. Metal support bases 120, 220 areconfigured to support insulative plates 130, 230, respectively, which,in turn, support electrically conductive sealing plates 140, 240thereon.

Metal support bases 120, 220 further include respective tissue-orientedsurfaces 128, 228. Tissue-oriented surfaces 128, 228 have the pluralityof ceramic stops 122 a-g, 222 a-g, respectively, extendingperpendicularly therefrom. Ceramic stops 122 a-g, 222 a-g haveelectrically insulative properties and are configured to electricallyinsulate jaw members 110, 210 when no tissue is disposed therebetween,act as an isolating spacer between jaw members 110, 210 to preventtissue from being over-compressed, assist the user in gripping tissueduring grasping, and assist in the assembly of jaw members 110, 210 byacting as guide-posts along which insulative plates 130, 230 and sealingplates 140, 240 may be guided into engagement with metal support bases120, 220, as described in greater detail below.

Ceramic stops 122 a-g, 222 a-g are relatively small in size to reducethe effect of ceramic stops 122 a-g, 222 a-g on tissue sealingperformance. For example, ceramic stops 122 a-g, 222 a-g may range fromabout 0.020 inches to about 0.050 inches in diameter. However, the sizeof ceramic stops 122 a-g, 222 a-g can vary based on the size of jawmembers 110, 210. In the illustrated embodiment, each ceramic stop 122a-g, 222 a-g is generally cylindrical and has a first end 123 a-g, 223a-g and a second end 127 a-g, 227 a-g. Each ceramic stop 122 a-g, 222a-g defines a longitudinal axis therethrough, e.g., axis “Y-Y” ofceramic stop 122 a. First ends, e.g., end 123 a, 223 a of eachrespective ceramic stop 122 a, 222 a are directly connected totissue-oriented surfaces 128, 228 of jaw members 110, 210. First ends123 a, 223 a of each ceramic stop 122 a-g, 222 a-g may be monolithicallyformed with, integrally connected to, or fastened to respectivetissue-oriented surfaces 128, 228 of jaw members 110, 210 via variousfastening engagements, such as, for example, adhesives, ultrasonicwelding, snap-fit engagement, etc.

Second ends, e.g., second ends 127 a, 227 a of each respective ceramicstop 122 a-g, 222 a-g includes a planar tissue-contacting ortissue-engaging surface 125 a (FIG. 3) that defines a planesubstantially parallel with tissue-oriented surfaces 128, 228 ofrespective jaw members 110, 210. The plane of each planartissue-contacting surface 125 a (FIG. 3) is in perpendicular relation toeach respective longitudinal axis “Y-Y” of each ceramic stop 122 a-g,222 a-g. Each planar tissue-contacting surface, e.g., surface 125 a(FIG. 3) of respective ceramic stops 122 a-g, 222 a-g has apointed/squared circumferential edge 137 (FIG. 3) designed to improvegrasping and holding of slippery tissue between jaw members 110, 210.Connecting ceramic stops 122 a-g, 222 a-g directly to metal supportbases 120, 220 more closely controls the height of the ceramic stops 122a-g, 222 a-g relative to the components that drive the actuation of jawmembers 110, 210, namely, the jaw pivot 103 and cam slots 126, 226 ofmetal support bases 120, 220.

With reference to FIGS. 4A and 4B, insulative plates 130, 230 andsealing plates 140, 240 each include a plurality of openings 132 a-g,232 a-g, 142 a-g, 242 a-g, respectively, defined therethrough. Openings132 a-g, 232 a-g of insulative plates 130, 230 and openings 142 a-g, 242a-g of sealing plates 140, 240 are coaxially aligned with one anotherupon assembly thereof to respective metal support bases 120, 220. Theelectrically conductive sealing plates 140, 240 and the insulativeplates 130, 230 include respective longitudinally-oriented knife slots139, 239, 149, 249 defined therethrough for reciprocation of a knifeblade (not explicitly shown). Openings 132 a-g, 232 a-g, 142 a-g, 242a-g of insulative plates 130, 230 and respective sealing plates 140, 240are disposed adjacent longitudinal knife slots 139, 239, 149, 249.Openings 132 a-g, 232 a-g, 142 a-g, 242 a-g are configured for receiptof respective ceramic stops 122 a-g, 222 a-g. Upon assembly of jawmembers 110, 210, ceramic stops 122 a-g, 222 a-g protrude a distancefrom sealing plates 140, 240 to prevent sealing plates 140, 240 fromtouching and creating a short between sealing plates 140, 240. Uponassembly of jaw members 110, 210, ceramic stops 122 a-g, 222 a-g areadjacent blade slots 139, 239, 149, 249 to help grip tissue closer towhere a division of the gripped tissue takes place, thus producing amore reliable cut.

In some embodiments, sealing plates 140, 240 may be affixed atop theinsulative plates 130, 230, respectively, and metal support bases 120,220, respectively, in any suitable manner, including snap-fit,over-molding, stamping, ultrasonic welding, etc. Metal support bases120, 220, insulative plates 130, 230, and sealing plates 140, 240 areencapsulated by the outer insulative housings 102, 202 by way of anovermolding process. Insulative housings 102, 202 may be fabricated fromvarious types of plastic materials, such as, for example, Amodel®,Trogamid®, PEKK, G-PEAK, PEEK, Thermotuff™, Ultem®, etc., all of whichmay be mineral and/or fiber reinforced.

During assembly, to form jaw member 110, metal support base 120 isformed and ceramic stops 122 a-g are cut to a selected length.Insulative plate 130 is formed by injection molding and includes alongitudinal knife slot 139 formed therein. Sealing plate 140 is formedfrom a conductive material and has a longitudinal knife slot 149 formedtherein. Openings 132 a-g are formed in insulative plate 130 andopenings 142 a-g are formed in sealing plate 140 adjacent respectivelongitudinal knife slots 139, 149. Ceramic stops 122 a-g are engaged totissue-oriented surface 128 (i.e., directly connected to tissue-orientedsurface 128) of metal support base 120 such that ceramic stops 122 a-gextend substantially perpendicular from tissue-oriented surface 128.Insulative plate 130 is coupled to metal support base 120 by guiding andaligning insulative plate 130 along ceramic stops 122 a-g untilinsulative plate 130 is in abutment with tissue-oriented surface 128 ofmetal support base 120. Sealing plate 140 is guided and aligned alongceramic stops 122 a-g toward metal support base 120 until sealing plate140 is in abutment with insulative plate 130 and second ends 127 a-g ofceramic stops 122 a-g protrude from sealing plate 140. Insulativehousing 102 is overmolded around metal support base 120 to secure thecomponents of jaw member 110 together. Jaw member 210 may be formed in asimilar manner as jaw member 110, described above.

This process avoids using high temperatures traditionally used toconnect ceramic stops 122 a-g, 222 a-g to a sealing plate 140, 240 of ajaw member 110, 210. Such high temperatures limit the materials that maybe used for fabricating sealing plates 140, 240. Accordingly, theprocess of forming the jaw members 110, 210 disclosed herein allows forsealing plates 140, 240 to be constructed from alternative materialsthat would not be able to withstand high manufacturing temperaturesnormally utilized during the application of ceramic stops 122 a-g, 222a-g to the sealing plates 140, 240. For example, the presently disclosedembodiments permit sealing plates 140, 240 to be constructed from aprinted circuit board, which may provide additional benefits forsurgical applications.

In one embodiment of the present disclosure, another process forassembling jaw members 110, 210 is provided. Instead of connectingceramic stops 122 a-g, 222 a-g directly to metal support bases 120, 220prior to coupling insulative plates 130, 230 and sealing plates 140 240to metal support bases 120, 220, respectively, insulative plates 130,230 and sealing plates 140, 240 are mounted to metal support bases 120,220 prior to engaging ceramic stops 122 a-g, 222 a-g to metal supportbases 120, 220. In particular, after insulative plates 130, 230 andsealing plates 140, 240 are mounted to metal support bases 120, 220,respectively, ceramic stops 122 a-g, 222 a-g are guided throughrespective openings 132 a-g, 232 a-g, 142 a-g, 242 a-g in insulativeplates 130, 230 and sealing plates 140, 240 into engagement with themetal support bases 120, 220. In this way, ceramic stops 122 a-g, 222a-g may be supported on metal support bases 120, 220 by being secured inopenings 132 a-g, 232 a-g, 142 a-g, 242 a-g of insulative plates 130,230 and sealing plates 140, 240. Ceramic stops 122 a-g, 222 a-g may beheld in engagement with metal support bases 120, 220 via a friction-fitconnection within openings 132 a-g, 232 a-g, 142 a-g, 242 a-g ofinsulative plates 130, 230 and/or sealing plates 140, 240. Similar tothe method of assembling jaw members 110, 210 described above, thisprocess avoids using high temperatures traditionally used to connectceramic stops to a sealing plate of a jaw member.

Any of the components described herein may be fabricated from eithermetals, plastics, resins, composites or the like taking intoconsideration strength, durability, wearability, weight, resistance tocorrosion, ease of manufacturing, cost of manufacturing, and the like.

The various embodiments disclosed herein may also be configured to workwith robotic surgical systems and what is commonly referred to as“Telesurgery.” Such systems employ various robotic elements to assistthe surgeon and allow remote operation (or partial remote operation) ofsurgical instrumentation. Various robotic arms, gears, cams, pulleys,electric and mechanical motors, etc. may be employed for this purposeand may be designed with a robotic surgical system to assist the surgeonduring the course of an operation or treatment. Such robotic systems mayinclude remotely steerable systems, automatically flexible surgicalsystems, remotely flexible surgical systems, remotely articulatingsurgical systems, wireless surgical systems, modular or selectivelyconfigurable remotely operated surgical systems, etc.

The robotic surgical systems may be employed with one or more consolesthat are next to an operating theater or located in a remote location.In this instance, one team of surgeons or nurses may prep the patientfor surgery and configure the robotic surgical system with one or moreof the instruments disclosed herein while another surgeon (or group ofsurgeons) remotely control the instruments via the robotic surgicalsystem. As can be appreciated, a highly skilled surgeon may performmultiple operations in multiple locations without leaving his/her remoteconsole which can be both economically advantageous and a benefit to thepatient or a series of patients.

The robotic arms of the surgical system are typically coupled to a pairof master handles by a controller. The handles can be moved by thesurgeon to produce a corresponding movement of the working ends of anytype of surgical instrument (e.g., end effectors, graspers, knifes,scissors, etc.) which may complement the use of one or more of theembodiments described herein. The movement of the master handles may bescaled so that the working ends have a corresponding movement that isdifferent, smaller or larger, than the movement performed by theoperating hands of the surgeon. The scale factor or gearing ratio may beadjustable so that the operator can control the resolution of theworking ends of the surgical instrument(s).

The master handles may include various sensors to provide feedback tothe surgeon relating to various tissue parameters or conditions, e.g.,tissue resistance due to manipulation, cutting or otherwise treating,pressure by the instrument onto the tissue, tissue temperature, tissueimpedance, etc. As can be appreciated, such sensors provide the surgeonwith enhanced tactile feedback simulating actual operating conditions.The master handles may also include a variety of different actuators fordelicate tissue manipulation or treatment further enhancing thesurgeon's ability to mimic actual operating conditions.

It will be understood that various modifications may be made to theembodiments of the presently disclosed jaw members and methods offorming said jaw members. Therefore, the above description should not beconstrued as limiting, but merely as exemplifications of embodiments.Those skilled in the art will envision other modifications within thescope and spirit of the present disclosure.

What is claimed is:
 1. A method of forming a jaw member of an endeffector, comprising; providing a metal support base, an insulativeplate having a plurality of openings defined therethrough, and a sealingplate having a plurality of openings defined therethrough; directlyconnecting a first end of each of a plurality of ceramic stops to atissue oriented surface of the metal support base, the ceramic stopshaving a predetermined length; and coupling the insulative plate and thesealing plate to the metal support base by aligning the plurality ofceramic stops through the plurality of openings defined in theinsulative plate and the plurality of openings defined in the sealingplate such that a second end of each ceramic stop projects apredetermined distance relative to a tissue-engaging surface of thesealing plate.
 2. The method according to claim 1, further comprisingforming a longitudinal knife slot through each of the insulative plateand the sealing plate and aligning the slots in registration with oneanother.
 3. The method according to claim 2, wherein the plurality ofopenings of the insulative plate and the plurality of openings of thesealing plate are formed adjacent each respective longitudinal knifeslot.
 4. The method according to claim 1, further comprising overmoldingan insulative housing around the metal support base.
 5. The methodaccording to claim 1, wherein the insulative plate is formed byinjection molding.
 6. The method according to claim 1, wherein each ofthe plurality of ceramic stops has a cylindrical configuration.
 7. Themethod according to claim 1, wherein each of the plurality of ceramicstops defines a longitudinal axis therealong and tissue-engaging surfaceof each of the plurality of ceramic stops defines a plane inperpendicular relation to each respective longitudinal axis.
 8. Themethod according to claim 1, wherein the insulative plate is fabricatedfrom plastic.
 9. The method according to claim 1, wherein thepredetermined distance is about 0.001 inches to about 0.006 inches. 10.The method according to claim 1, further comprising: moving theinsulative plate and the sealing plate in a direction toward theplurality of ceramic stops; and moving the insulative plate and thesealing plate along the plurality of stops toward the metal supportbase.